What it’s like to be a little man in Bangladesh

Md Emad Chowdhury wore a crisp white shirt, black trousers and gleaming leather sandals. His well-groomed beard matched his polished appearance. As he moved toward the exit, someone quickly stood up to open the regular-sized glass door for him—something that often happens.

At 34, Emad is a Dhaka-based journalist living with dwarfism. 

Standing just 3.5 feet tall, he's accustomed to people "helping" him with tasks he can easily manage independently. But despite his height, Emad walks through life with his head held high, navigating the bustling streets of Dhaka on public transport and rickshaws. The curious stares from bystanders, rickshaw pullers and bus conductors are a constant in Emad's navigation. 

"There have been days when I boarded a public bus, and people immediately pointed me to the seat for the 'disabled.' They stared at me the entire time. I understand it's a concern but the looks stay with me," Emad said with a laugh. 

His ability to laugh off such experiences stems from the strong foundation he built his life on growing up. "And sometimes, rickshaw pullers ask for double or triple the fare, assuming I don't know better or that I'm easier to fool," he added. 

While Emad's height draws unsolicited assistance, few realise that his condition, Achondroplasia (a bone growth disorder caused by a genetic mutation) doesn't hinder his ability to live an independent life. It is the most common form of disproportionate short stature, with distinct physical features such as a larger head, prominent forehead and shortened limbs. 

Yet, medical terms do little to capture the spark in his bright eyes or Emad's infectious smile.

"In medical terms, we refer to it as 'short stature' rather than 'dwarfism,'" explained Dr Robi Biswas, a paediatric endocrinologist at Dhaka Shishu Hospital. "If it's genetic, there's no cure as it's not a disease but a condition."

October is International Dwarfism Awareness Month and 25 October is celebrated as Dwarfism Awareness Day. By speaking to Emad and through his lens, The Business Standard explored the realities of those living with dwarfism in Bangladesh and how family support can bring a short-statured person to the mainstream.

The genetics behind Emad's condition

Emad grew up in a residential area in Panchlaish, Chattagram. Emad's father, who passed away in 2015, also had disproportionate dwarfism, while his mother is of average height. His elder sister shares the condition, while his younger brother, now 32, is of average height. 

According to a doctor's consultation, Emad and his sister inherited their genetic structure from their father's side, while their younger brother inherited traits from their mother's side.

As a journalist, it was during his interviews with doctors that Emad discovered the fact that he got this genetic condition from his family. In conversations with doctors, Emad learned that his family's history of consanguineous (first-cousin) marriages likely contributed to his genetic condition.

"In my family, there are multiple first-cousin marriages and even a couple of second-cousin marriages as well. The doctors said if first cousins who are being married have the same blood groups, and similar genetic issues, such genetic mutations can happen among the offspring," said Emad. 

In 2012, the National Institutes of Health (NIH) showed that first-cousin marriages increase the chances of recessive genetic conditions as parents share a higher percentage of genetic material, which increases the risk of recessive problems in their children. 

"The closer the biological relationship between parents, the greater the probability that their offspring will inherit identical copies of one or more detrimental recessive genes," the article says. 

Could Achondroplasia be caused because of this? There has not been any research on this in the Bangladeshi context.  

However, in a 2022 study, titled Clinico Epidemiological Profile of Short Stature at A Tertiary Care Centre in Bangladesh, Dr Biswas found that 36% of cases of short stature in children were genetic in origin, often inherited through family members. They surveyed 100 children, aged 3-14 years, with short stature. 

In the research, they concluded that with endocrine causes, chronic systemic illnesses and malnutrition still form a major bulk in the etiological profile of SS in Bangladesh.

"There is no specific data regarding the overall prevalence of SS condition in Bangladesh, however, there are hundreds of causes for it," explained Dr Biswas. 

Although Emad's short stature is genetic, according to Dr Biswas, other causes such as malnutrition, hormonal imbalances and chronic diseases can also contribute to short stature in Bangladesh.

According to Little People of America, or LPA, a US-based organisation that supports individuals with dwarfism, there are about 400 different types of dwarfism, which can occur in one in every 10,000 births. 

Additionally, people with dwarfism can be born into families with average height. 

In 2020, a group of researchers published a paper titled Skeletal Dysplasia: a series of five cases of Bangladesh demonstrating classical achondroplasia, and the result shows that they are mostly born to normal-height parents. 

In the paper, they mentioned, "From the ease of obtaining the cases, it is apparent that achondroplasia is not a very rare condition, but certainly not one that has been paid enough attention to in Bangladesh, with sufferers not near-enough receiving the care and support that they may well benefit from."

There is no cure for this genetic disorder. However, they need mental support from the family and society. Whether a child has this disorder or not, can be measured from an early age. 

The American Academy of Pediatrics committee recommended parents and child specialists to monitor height, weight and head circumference, using growth charts standardised for achondroplasia in children. Also, a paediatric orthopedist is to be consulted if bowing of the legs interferes with walking. 

At home vs out in the world

Emad did his schooling in Chattagram. While his brothers and cousins attended Chattagram Govt School and College, Emad went to a nearby school due to concerns about his ability to commute.

He would not be able to travel in local buses, Emad was told. 

"Growing up with an accepting family and friends, I never felt out of place, never an outsider", Emad continued. "I feel it was my family's education, their philosophy of life that created such a healthy environment", he added.

He credits his family for keeping him close to his roots, both emotionally and metaphorically. "People are often surprised to hear that I used to play in local cricket and football tournaments with my average-height friends," he said. "And I wasn't just a participant—many of my old teammates still call me when I'm back in Chattagram, reminiscing about my achievements in those games."

"He played really well with all of us. Maybe because we were children back then, we never felt like he was any different from us. And as we grew up, it didn't matter anymore whether he was of average height or not," said Md Robiul Hossen, Emad's childhood friend.

After higher secondary studies, Emad was accepted to the Department of Mass Communication and Journalism at Chattagram University in 2007. 

He remembers his uncle, one of his father's cousins, who was a journalist. "When I was in sixth standard, my uncle was a special correspondent for Ittefaq. I was captivated by the way he moved through the world—uncovering stories, travelling the country and engaging with so many people. It planted a seed in me, long before I knew I'd follow the same path," Emad recounted.

So from that early stage, Emad started writing his stories, and some of his poems got published in local newspapers. "I had a fabulous life at my university. From teachers to administrative officers to peons, everyone knew me. I started doing journalism at my university during my second year," he said.

"When I told my father I had chosen journalism over the safer paths of BBA or English, he went silent for two days. Then one day, one of my cousins, who is a teacher of applied physics at Chattagram University, had a conversation with my father and he was convinced. 

After that, everything was normal again between me and my father," Emad recalled and chuckled. Later, his father became very supportive. 

"When I started doing journalism, Abba used to give me ideas for writing. My parents and my relatives regularly read my stories in the newspaper. This was something that inspired me," he added. 

This way, they did not let Emad realise the fact that he is not one of the "normal" people, nor did they treat him like a special person. When his brother made his bed in the morning, Emad had to do the same. He cleaned his stuff and played with his friends of average height. 

"In the family, I along with my other siblings and cousins were taught to do chores like changing the bulb, mending something in the home, running errands, etc. My mother tried to get me to the kitchen to learn stuff and eventually, when I moved to Dhaka, I cooked," he said. 

All this inspired confidence in Emad. 

Looking back now, Emad realises how much his family's support shaped him. "That [family] environment was a gift, and it's something I'll carry forward into my own family," he said. Emad is a new father, their child Borno is seven months now. 

Emad and Ainun Nahar married in 2022. The couple has been to doctors and in particular wants to know whether the child is going to have dwarfism or not. Though Ainun is of average height, Emad is eager to know if their child might inherit his condition. He also spoke of his mixed feelings – joy and anxiety as he awaits fatherhood.

A loving and supportive family "doesn't mean I never faced discrimination outside," Emad added.

"There were times when buses would speed past me at stops, unwilling to wait for the extra moment I needed to climb aboard. They assumed I'd be a hassle, so they just kept going," said Emad, adding, "In the past, I would protest and speak out against such treatment, but over time, I've learned to accept it, even though it still hurts."

There are positive examples too. When Emad lived in Kalyanpur, he used to ride a specific bus daily. Once the conductors began to recognise him, they would stop, smile and help Emad get on the bus when they spotted him. 

It's the same with some of the rickshaw pullers in his area. "A few of them know me now, and whenever they see me on the road, they call out and offer me a ride. These small gestures really make me happy," he added.

Urban design is another problem. Dhaka's footpaths are generally too high and uneven, meaning Emad sometimes has to use his hands to climb it. "Even something as simple as getting onto a footpath requires extra caution, especially when I'm dressed for work. It's a constant reminder that the world isn't built for someone like me," Emad said.  

At his workplace, Emad mentioned how swivel chairs are helpful as they are usually adjustable in height. "I remember in one of my previous offices, my boss made a high chair, just for me, so that I could sit on that and work comfortably on the desks," he said. 

"As a small man, my wish is that when someone sees a dwarf, rather than being scared or intimidated, have the education and knowledge to learn more about the condition. Approach someone with dwarfism and ask questions. Learn to treat someone with dwarfism with respect and dignity," he concluded.